history chapter 1

• religion in medicine


  - The Christian Church was dominant in medieval society

  - Belief in religious and supernatural causes of illness were common

  - disease was a punishment from sin
• God and the cause of disease


  - the Church taught that God made them ill because he was either displeased with them or was testing their faith

  - his was an acceptable explanation for the cause of illness.

  - This belief, and trust in ancient medical practices --> held back medical research + meant that few new ideas about the causes of disease appeared in medieval times

  - causing continuity about ideas about disease
• Astrology


  - The alignment of planets and stars was thought to cause some diseases

  - Astrology was used to help diagnose what was wrong with a patient

  - Use of astrology wasn't new in 1250 but it increased through this period, especially after the Black Death.
• importance of the church in everyday life- education


  - people were educated by the church

  - centre of formal learning

  - ran universities where physicians were trained

  - monks and priests could read and write

  - books were in monasteries

  - therefore monasteries had a lot of influence over what books were written and read

  - dissections were performed at university, but weren't common

  - knowledge of the anatomy didn't advance
• the importance of the church- disease


  - approved traditional, rational explanations for disease

  - specifically explanations that aligned with christian beliefs
• monasteries and nunneries


  The Church also taught that people should follow Jesus' example and care for the sick. Many hospitals were housed in monasteries and nunneries
• explanations for disease in medieval england


  - still based on ideas from the Ancient world, in particular those of Hippocrates and Galen

  - continuity of ideas
• The Four Humours


  - The Ancient Greeks thought everyone had a mix of four humours in their body

  - they believed people became ill when this mix was unbalanced --> so to make people better they tried to put this balance right

  - These ideas continued well into the Middle Ages

  
• Galen


  - greek doctor

  - worked in ancient rome

  - wrote many book about his ideas

  - they were the basis of medical training in the middle ages

  - developed Hippocrates ideas and mainly used bloodletting, or purging, to prevent and treat illness

  - created the theory of the opposites

  
  

  drew detailed diagrams of the human anatomy using knowledge he gained from operating on wounded gladiators + carrying out dissections on dead bodies
• Hippocrates


  - an Ancient Greek doctor

  - His ideas and books were very influential well into medieval times and beyond

  - He dismissed the idea that gods caused disease --> believed there was a physical reason for illness, which needed a physical cure

  - Most of his treatments were based on diet, exercise and rest but he also used bleeding and purging

  to get rid of excess humours

  - He wrote the Hippocratic Oath, where doctors swore to respect life and prevent harm

  - His method of clinical observation - studying symptoms, making notes, comparing with similar cases, then diagnosing and treating --> is the basis of the approach used today.
• miasma


  - Another theory about the cause of disease was that it was transmitted by 'bad air'

  - This was related to God because bad smells indicated sin.

  - originated in the Ancient world but continued into the Middle Ages and well into the 19th century.
• Prevention and treatment of disease in the Middle Ages


  based on rational and religious methods as well as traditional remedies
• Rational treatments in connection with the Four Humours 1)


  - Bloodletting (most common treatment)

  - which was cutting a vein, using leeches or by cupping

  - Different points in the body were used for different illnesses

  - Occasionally bloodletting was performed by physicians but, more usually, it was done by barber-surgeons or non-medical persons
• Rational treatments in connection with the Four Humours 2)


  - Purging

  - involved making a patient vomit

  - or go to the toilet to remove food from the body

  - Emetics and laxatives were mixed by apothecaries, wise women or, at the patient's home, physicians prescribed treatments and sometimes gave enemas themselves.
• Traditional remedies


  - most common remedies were traditional ones made with herbs, which were drunk, sniffed or bathed in

  - Remedies also included different foods to rebalance the humours and ointments to apply to the skin

  - They were made at home or mixed and sold by an apothecary
• Religious treatments


  - Praying

  - Fasting

  - Going on pilgrimage

  - Paying for a special

  - Mass to be said
• Supernatural treatments


  - Supernatural treatments included specific ideas for certain illnesses

  - such as hanging a magpie's beak around your neck to cure toothache.
• preventing disease: Religious and supernatural methods


  - Living a Christian life --> praying, going to church, and obeying the Commandments

  - Carrying lucky charms or amulets

  - Self-punishment, such as flagellation --> punishing yourself so God wouldn't

  - Chanting incantations
• preventing disease: Rational methods


  - Trying to keep streets clean

  - Bathing and washing

  - Exercising

  - not overeating

  - Bleeding and purging

  - Purifying the air
• who treated the sick in the Middle Ages


  - Barber-surgeons

  - Care in the home

  - Apothecaries

  - Physicians
• Barber-surgeons


  • No training

  • Carried out bloodletting, pulling teeth and lancing boils.

  • Did basic surgery such as amputating limbs (very low success rate)

  • Cost less than a physician
• care in the home


  • Most ill people throughout this period were treated at home by a female family member

  • The village 'wise woman', often the Lady of the Manor

  - would also tend to people in their homes for free.
• Apothecaries


  • Received training but no medical qualifications

  • Mixed medicines and ointments based on their own knowledge or directions of a physician

  • Cost money (but less than a physician).
• Physicians


  • Medically trained at university and passed exams

  • Diagnosed illnesses and gave treatments, or sent patients to the apothecary or barber-surgeon

  • Expensive, so mainly used by the wealthy

  • Very few of them, with women physicians incredibly rare.
• What physicians did


  1. Commonly, physicians observed a patient's symptoms and checked their pulse, skin colour and urine (for both colour and taste!). 2. They consulted urine charts in their vademecum (handbook)

  3. They then consulted zodiac charts to help diagnose the illness and to work out the best time to treat the patient. 4. They then either treated patients themselves (though this was rare), or sent them to a barber-surgeon or apothecary
• Hospitals: patients


  - Patients and their surroundings were kept very clean

  - were given fresh food and plenty of rest.

  - Usually, people with infectious diseases or incurable conditions were not admitted

  - Some hospitals were built for specific infectious diseases
• Hospitals: building etc


  - The number increased during the Middle Ages

  - Hospitals were places of recuperation rather than places where patients were treated for disease

  - Many were run by the Church, so the emphasis was on God and healing souls

  - Many hospitals were places where travellers and pilgrims stayed on their journeys
• The Black Death


  reached Britain in 1348, killing about one-third of the population
• what was the black death like


  - historians today think this disease was bubonic plague

  - carried by fleas living on black rats, which brought the disease to different countries on trading ships

  - Bubonic plague is passed to humans when an infected flea bites them and the disease enters their blood
• Causes and avoidance: religion


  - God sent the plague as a punishment for people's sins

  
  

  
  

  - Praying and fasting: because people believed that God had sent the disease, it made sense to show God they were sorry by punishing themselves
• Causes and avoidance: Astrology


  - the position of Mars, Jupiter and Saturn was unusual at this time
• Causes and avoidance: Miasma


  - bad air or smells caused by decaying rubbish

  
  

  
  

  - Clearing up rubbish in the streets

  - Smelling their toilets or other bad smells, in the belief this would overcome the plague

  - Carrying herbs and spices to avoid breathing in 'bad air
• Causes and avoidance: Four humours


  - most physicians believed that disease was caused by an imbalance in the Four Humours
• Causes and avoidance: outsiders


  - strangers or witches had caused the disease.

  
  

  
  

  - Not letting unknown people enter the town or village
• Symptoms of the Black Death included:


  - swelling of the lymph glands into large lumps filled with pus (buboes)

  - fever and chills

  - headache

  - vomiting, diarrhoea and abdominal pain.
• Treatments for the Black Death included:


  - praying and holding lucky charms

  - cutting open buboes to drain the pus

  - holding bread against the buboes, then burying it in the ground

  - eating cool things and taking cold baths.